Chapter 33: Care of Patients with Musculoskeletal and Connective Tissue Disorders

Chapter 33: Care of Patients with Musculoskeletal and Connective Tissue Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient has come to the ambulatory care clinic with a sprain. The nurse correctly differentiates a grade 2 sprain from a grade 3 sprain with the assessment of:

a.	pain.
b.	swelling.
c.	bleeding into the joint.
d.	minor loss of function.

 

 

ANS:  D

The minor loss of function is the differentiating factor. Pain, swelling, and bleeding into the joint are true of both grade 2 and grade 3 sprains. A grade 3 sprain has loss of function of the joint.

 

DIF:    Cognitive Level: Application           REF:   734                OBJ:   1 (theory)

TOP:   Sprains: Grade 2                             KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. An older adult has fallen and sprained his ankle in a local park. The correct initial management of the injury will include which action?

a.	Elevating the foot to reduce swelling
b.	Applying ice to delay swelling
c.	Administering aspirin to combat pain
d.	Having the person ambulate to test for ability to bear weight

 

 

ANS:  A

Elevation is the initial intervention as it can be done immediately. Applying ice and medicating for pain will follow quickly.

 

DIF:    Cognitive Level: Comprehension     REF:   734                OBJ:   1 (theory)

TOP:   Sprain: First Aid                              KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

3. When the clinic nurse starts to take the “air cast” off the grade 2 sprain, the patient asks why it is being removed as he still has pain. The nurse explains that the cast is removed because:

a.	the cast will interfere with adequate circulation.
b.	the cast will increase the edema.
c.	long-term immobilization can cause permanent disability.
d.	another heavier cast will be applied.

 

 

ANS:  C

Lengthy immobilization can lead to permanent disability. Casts and splints are left on only until the joint is strengthened.

 

DIF:    Cognitive Level: Comprehension     REF:   734                OBJ:   1 (theory)

TOP:   Splinted Sprain: Complications        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. The nurse recognizes a need for further instruction about application of ice to a sprain when the patient says:

a.	“I know this ice will reduce the swelling.”
b.	“I will keep the ice on this knee for the rest of the day.”
c.	“I will use the ice as you have directed for 24 hours.”
d.	“I can elevate my leg and use ice to reduce swelling.”

 

 

ANS:  B

Ice should be applied for 20 minutes of each hour for the first 24 hours.

 

DIF:    Cognitive Level: Application           REF:   734                OBJ:   1 (theory)

TOP:   Ice: Duration of Application            KEY:  Nursing Process Step: Evaluation

MSC:  NCLEX: Health Promotion and Maintenance

 

5. The industrial nurse examines an employee who states that his right shoulder hurts when he abducts it and points with one finger to the spot at the point of his shoulder that is painful. He mentions that he won a racquetball tournament yesterday. The nurse suspects the employee is suffering from:

a.	rotator cuff tear.
b.	bursitis.
c.	dislocation.
d.	subluxation.

 

 

ANS:  B

Bursitis occurs after overuse, with pain in the joint on activity with no erythema and little, if any, swelling. Dislocations are very painful and the pain is spread all over the shoulder. The shoulder also looks misshapen in a dislocation. Rotator cuff tear would prevent the patient from abducting his shoulder.

 

DIF:    Cognitive Level: Analysis                REF:   736                OBJ:   1 (theory)

TOP:   Bursitis: Signs and Symptoms          KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance